Meningococcal disease in Canada: surveillance summary to 1987.

Meningococcal disease continues to occur in most parts of Canada at endemic levels, with minor fluctuations. The incidence in general has changed very little over the past three decades. It is primarily a childhood infection, occurring most commonly among infants less than 1 year of age. In 1987 the risk of infection among infants in that age group was 4 times and among those aged 1 to 4 years 2.5 times that of the general population. The most susceptible appear to be infants about 3 months of age. The annual CFRs had exceeded 50% before the antibiotic era, but with early diagnosis, modern therapy and supportive measures they have been less than 10%. A revised form for reporting cases, currently being considered by provincial epidemiologists across Canada, could help to provide more clinical and epidemiologic information.     

Meningococcal meningitis in children.

Forty-four cases of meningococcal meningitis in children at one hospital between 1971 and 1975 inclusive were studied to document the course and complications of this disease in children in the current therapeutic era. The mortality was 5%. Of the 41 survivors 76% were healthy 1 to 5 years after the episode of meningitis. Permanent severe sequelae (facial palsy, optic atrophy and ptosis) were seen in three (7%) of the survivors, and mild hearing loss, hyperactivity and nervousness were noted in seven (17%). Electroencephalography was not useful in determining management or prognosis. Both the mortality and the frequency of early and late complications among the survivors were lower than those reported from earlier studies.     

Biosecurity in Scandinavia

This article investigates the extent to which biosecurity measures are recognized and have been implemented in the Nordic countries, in the absence of formalized security standards and legislation. Two trials were undertaken: first, a broad combined biosafety and biosecurity questionnaire survey of the Nordic countries, and, second, a focused on-site audit of 22 facilities, with 94 laboratories, in Denmark. Both trials indicated that external security had been partially implemented but that little attention had been paid to internal security and the establishment of biosecurity. It was demonstrated that the backgrounds and identities of insiders were rarely checked and that they could have gained access to both pathogen inventory lists and freezers in many facilities. In 81% of pathogen-containing facilities, pathogens were not routinely and centrally accounted for. The authors recommend the establishment of a legal framework congruent with international standards and obligations; novel governmental national biosecurity authorities, requiring a fusion of both microbiological and technical expertise and legislative powers; and the formulation of a new code of conduct termed "Good Biosecurity Practice."